Let’s Talk Mold
Takeaways from the ISEAI 2019 Inaugural Conference May 2019.
Day 1 Dr. Joseph Brewer on Mold and Mycotoxins
By the time you finish reading these blogs, you will understand how flooded our brains were from this conference. I have heard most of the speakers before on Youtube, but spending 2 ½ days bathed in decades of clinical experience was quite the dousing. Joseph Brewer MD shared years of his experience during day 1 discussing mold, mycotoxins, and where mold can be found in the body.
Take Away Points:
- Different molds produce different toxins with different effects.
- A high percentage of Chronic Fatigue Patients test positive for mycotoxins in their urine.
- Mycotoxins produce symptoms and illness through a variety of mechanisms.
- Brewer believes that mold can colonize the nasal passages of patients and produce internal toxins.
After present a case of mycotoxin illness and describing the events leading up to indoor mold growth, Dr. Brewer shared a slide listing which mold produce which toxins. This stands out as one of those useful chunks of information which is easier to laminate than memorize. When faced with ERMI tests showing an Aspergillus, it may help to match that with ochratoxin or gliotoxin produced by various Aspergillus strains. This reminds me that while I infrequently use the urine mycotoxin testing, it can sometimes be helpful to determine which of two mold sources is the likely source of my patient’s exposure. Say their workplace has aspergillus on ERMI testing, but their home has stachybotrys species of mold. If their urine shows more tricothecenes and minimal to no ochratoxin and gliotoxin, then the are more likely being affected by their home environment.
Dr. Brewer shared his study report concerning the high percentage of Chronic Fatigue Syndrome (CFS) patients who have mycotoxins in their urine. While further studies and validation deserve time and resources, it does at least cause one to pause and think how many are not being diagnosed correctly in CFS.
Dr. Brewer spent some time outlining the actual mechanisms by which mold toxins damage our health. These nasty little toxins may bind directly to DNA and RNA. They may alter the production of proteins as well as alter their functions. Oxidative stress may worsen. Antioxidants may be used up. Mitochondria can be hindered from producing energy. The immune system can be dysregulated. A major mechanism is through hyperactivation of mast cells which then produce further downstream effects. Multiple ways that these toxins can disrupt our bodies’ functions and produce illness.
A controversy surrounds whether patients may harbor mold in their sinuses which then produce mycotoxins in our body. Dr. Shoemaker is adamantly opposed to the idea whereas Dr. Brewer is very convincing of the opposite. Ultimately, I do believe a few patients may harbor these in their sinuses, or even lungs, but most do not. If we happen to treat for MARCONS with silver nasal spray, we are covering the possibility regardless, so I rarely check with a test for the fungus’ presence.
Overall, Dr. Brewer provided a great review of the illness and some literature support for it. Very informative.